Name: Application for Admission
SKU: 16169
Availability: InStock

Applicant (Child) Information

Applicant's full name*

First Last

Applicant's date of birth*

Applicant's age*

Applicant's gender (optional)

Male
Female

Ethnic group (optional)

African American
Caucasian
Middle Eastern
Latino/Hispanic
Asian American
Native American
Multiracial

Grade your child will be entering*

Start date*

Child's special interests*

Does your child have any special academic, emotional or social needs?*

Does your child have an IEP, 504 plan or any other academic accommodations?*

If you answered yes to the question above, please include a copy of any special academic plans or pertinent documentation.

Max. file size: 16 MB.

What schools has your child attended in the last 3 years?*

Please provide names, addresses, and dates of attendance. One per line.

How did you hear about Good Shepherd?*

Is there anything else you would like to share about your child?*

Parent contact information

Which parent does the child reside with?*

Father
Mother
Both

Is either parent forbidden by court order from having equal access to the child or his/her school records?*

Parent 1*

Father
Mother
Grandparent

Parent 1 Name*

Parent 1 Address*

Street Address Address Line 2 City State ZIP Code

Parent 1 Phone*

Parent 1 Email*

Parent 1 Occupation*

Parent 2*

Father
Mother
Grandparent

Parent 2 Name*

Parent 2 Address*

Street Address Address Line 2 City State ZIP Code

Parent 2 Phone*

Parent 2 Email*

Parent 2 Occupation*

Sibling's Information

Does your child have any siblings? If yes, what school(s) do they attend?*

Sibling Name(s) and Age(s)*

Church Affiliation (optional)

KINDERGARTEN THROUGH 5TH GRADE ONLY: Please also submit the Teacher Recommendation, a Personal Reference and Transcripts (academic records). These three items must be submitted before an applicant can be considered for admission.

I hereby waive my right to inspect and review any reference which may be requested by Good Shepherd School regarding my application with the understanding that:

1. These comments may be used only for the purposes of evaluating my qualifications for entrance to Good Shepherd School and will not be available to any other institution, organization or private party.

2. This waiver will remain in effect until I notify Good Shepherd School in writing, at which time these documents will be removed from the file and returned to the author or destroyed.

Parent's Signature*

Date*

A non-refundable application fee of $50 must accompany this application.